Individual provider Active NPI

Alejandro Interian, PHD

  • Clinical Psychologist
  • East Orange, NJ
National Provider Identifier
1659451391
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00428600 Issued in NJ
Practice address
385 Tremont Ave
East Orange, NJ 07018-1023
Phone
(973) 676-1000
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00428600 NJ Primary
Psychologist 103T00000X 35SI00428600 NJ

Addresses

Primary practice location

385 Tremont Ave
East Orange, NJ 07018-1023

Mailing address

385 Tremont Ave
East Orange, NJ 07018-1023

Other identifiers 1

IdentifierTypeStateIssuer
0094188MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35SI00428600NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program Psychologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1659451391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 TREMONT AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 TREMONT AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181023",
            "telephone_number": "973-676-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTERIAN",
        "first_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00428600",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00428600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094188",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.